Nature and Science of Sleep最新文献

{"title":"Restoring Physiological Normoxia as an Adjuvant Strategy to Improve Cancer Treatment Outcomes.","authors":"Carlos Mas Bermejo, Carlos Mas Gómez, Ma-Agustina Sevilla-García, Carlos O'Connor-Reina, Susana Falardo Ramos, José Luis Alonso-Romero, Luis-Alberto Bravo-González","doi":"10.2147/NSS.S593331","DOIUrl":"10.2147/NSS.S593331","url":null,"abstract":"<p><p>Hypoxia is a central driver of cancer progression, immune evasion, and resistance to anticancer therapies. While hypoxia has traditionally been considered an intrinsic feature of the tumor microenvironment, growing evidence indicates that chronic intermittent hypoxia-particularly that occurring during sleep-represents a systemic and potentially modifiable contributor to hypoxia-driven oncogenic signaling. Sleep-disordered breathing is the most prevalent cause of nocturnal intermittent hypoxia and induces oxidative stress, inflammation, metabolic reprogramming, and immune dysregulation through mechanisms that overlap with those observed in hypoxic tumors.This narrative review synthesizes current experimental, translational, and clinical evidence supporting the concept that restoration of physiological normoxia, especially during sleep, may attenuate hypoxia-mediated cancer biology and improve responsiveness to standard anticancer therapies. We examine the biological effects of normoxia restoration on hypoxia-inducible signaling, redox homeostasis, tumor metabolism, and antitumor immunity, highlighting its potential role as a host-directed, adjuvant strategy rather than a direct tumor-targeting intervention.We further review sleep and airway-centered therapeutic approaches capable of reducing nocturnal hypoxic burden, including continuous positive airway pressure, mandibular advancement devices, upper airway surgery, myofunctional therapy, and respiratory physiotherapy. Although these interventions are not cancer-specific, their ability to stabilize nocturnal oxygenation positions them as clinically relevant tools within a multidisciplinary framework aimed at hypoxia normalization.Collectively, the evidence suggests that nocturnal normoxia is a biologically meaningful and clinically actionable target. Integrating sleep and airway interventions into cancer care pathways may represent a novel avenue to mitigate hypoxia-driven treatment resistance and enhance therapeutic outcomes. Prospective clinical studies incorporating objective measures of hypoxic burden are warranted to validate this integrative approach.Restoration of physiological normoxia is therefore proposed as a host-directed, adjuvant strategy aimed at mitigating hypoxia-driven oncogenic pathways and improving responsiveness to standard anticancer therapies.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"593331"},"PeriodicalIF":3.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chloral Hydrate in the Treatment of Severe Insomnia When Other Treatments Have Failed: Results From a Real-World Evidence Study (RESTORE).","authors":"John A Groeger, John Luke Twelves, Jan Multmeier, Hannah Swayze, Mushtaque Mastim Snr, Adrian Williams, Stephen Deacon","doi":"10.2147/NSS.S587588","DOIUrl":"10.2147/NSS.S587588","url":null,"abstract":"<p><strong>Study objectives: </strong>The efficacy and safety of chloral hydrate, used as approved for severe insomnia in the UK, were assessed in a single-arm, open-label, real-world, decentralized clinical trial using contemporary self-reported outcome measures.</p><p><strong>Methods: </strong>Participants (18-75 years) had clinically significant impairment by severe insomnia (Insomnia Severity Index (ISI) score of 20-28), and history of behavioral and pharmacological sleep therapy failure. Specialists confirmed the clinical diagnosis and prescribed chloral hydrate (500 mg/5 mL oral solution, 430 or 860 mg daily) for 2 weeks followed by a 4-week follow-up period. Endpoints included change in ISI score from confirmatory diagnosis to treatment end (primary); and sleep measures, health-related quality of life (HRQoL), anxiety, depression, and adverse events (AEs; secondaries).</p><p><strong>Results: </strong>Of the 96 participants (mean baseline ISI, 24.03 [SD, 2.06]), 85 completed the study. Improvements were observed with ISI at treatment end (week 2 mean change was -10.79 [95% confidence interval, -12.12, -9.47]; n=93; week 6 mean change was -8.04 (95% confidence interval, -9.13, -6.95; p < 0.0001; n=85), exceeding the 6-point change considered a minimal clinically important difference. Self-reported sleep measures including Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, HRQoL, and anxiety shows significant improvements during treatment with some outcomes indicating continued benefit up to 4 weeks post-treatment. Most treatment-related AEs were mild in nature (83.9%, 256/305 events) including wind (73.9%), headache (58.7%), and stomach pain (31.5%). While no events met criteria for serious or severe intensity, seven participants (7.6%) withdrew owing to AEs.</p><p><strong>Conclusion: </strong>Short-term UK-approved chloral hydrate may provide a potential option for severe adult insomnia only when prior treatments have failed.</p><p><strong>Trial registration: </strong>NCT06053840 (https://clinicaltrials.gov); ISRCTN10433315 (https://www.isrctn.com/).</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"587588"},"PeriodicalIF":3.4,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148032998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polysomnographic Characteristics and Sleep Disorders in Pediatric Moyamoya Arteriopathy.","authors":"Kantisa Sirianansopa, Reshma Amin, Jackie Chiang","doi":"10.2147/NSS.S596046","DOIUrl":"10.2147/NSS.S596046","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to describe the polysomnographic characteristics and sleep-related symptoms in pediatric patients with Moyamoya arteriopathy (MMA) referred for sleep evaluation.</p><p><strong>Patients and methods: </strong>We conducted a retrospective case series of pediatric patients with MMA who were referred to the sleep clinic at The Hospital for Sick Children, Toronto, Canada, and underwent level 1 polysomnography (PSG) between 2014 and 2024. Clinical, demographic, genetic, and sleep-related data, including PSG and multiple sleep latency test (MSLT) findings were reviewed.</p><p><strong>Results: </strong>Eleven pediatric patients were included, with a median (IQR) age of 15 (13, 17) years. Sleep fragmentation was commonly observed on PSG (n=10, 90.9%), while no patients demonstrated clinically significant sleep-disordered breathing. A trend toward shorter REM latency was noted compared with age-matched normative values. Daytime fatigue was the most frequently reported symptom (n=6, 54.5%). Two patients underwent MSLT due to persistent hypersomnolence; one met diagnostic criteria for narcolepsy.</p><p><strong>Conclusion: </strong>In this retrospective case series, sleep fragmentation and a trend toward shorter REM latency were commonly observed in pediatric patients with MMA. However, given the small sample size and absence of pre-revascularization baseline data, these findings should be interpreted with caution. These results are descriptive and hypothesis-generating, and further prospective studies are needed to better understand sleep disturbances in this population.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"596046"},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Work Stress and Sleep Disorders in Law Enforcement: A Systematic Review and Meta-Analysis.","authors":"Huaihan Yang, Shuchen Tang","doi":"10.2147/NSS.S601666","DOIUrl":"10.2147/NSS.S601666","url":null,"abstract":"<p><strong>Background: </strong>Law enforcement personnel face diverse occupational stressors, including shift work, organizational pressure, operational demands, and traumatic incidents. Previous systematic reviews have primarily focused on prevalence estimates of sleep disturbances, whereas the strength of the association with occupational stress and the relative contribution of distinct stressor domains remain to be systematically quantified.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD420261284369). Four databases (PubMed, Cochrane Library, Web of Science, and SpringerLink) were searched from inception to January 2026. Observational studies using validated instruments to assess occupational stress and sleep outcomes were included. A random-effects model was used to pool odds ratios (ORs). Subgroup analyses distinguished three stressor domains: shift work, work and organizational stress, and dual stress exposure.</p><p><strong>Results: </strong>Seventeen studies were included in the qualitative synthesis, of which ten (N = 5124) provided data for meta-analysis. Occupational stress was significantly associated with sleep disorders (pooled OR = 3.51, 95% CI: 2.54-4.84), with moderate to substantial heterogeneity (I² = 69%). Subgroup analyses showed that shift work (OR = 3.02), work and organizational stress (OR = 5.94), and dual stress exposure (OR = 3.66) were each associated with elevated sleep risk, with no significant subgroup difference (P = 0.19). The dual stress exposure subgroup exhibited high heterogeneity (I² = 87%), possibly attributable to differences in measurement tools, study populations, and confounder adjustment.</p><p><strong>Conclusion: </strong>This study provides a quantitative estimate of the association between occupational stress and sleep disorders in law enforcement personnel. Differentiating occupational stress into distinct stressor domains may help clarify its relationship with sleep, with different stressors potentially operating through distinct pathways (eg, circadian disruption, cognitive rumination, hyperarousal). Methodologically, the study highlights issues in measurement standardization and confounder adjustment. From an intervention perspective, organizational-level strategies-such as enhancing decision-making autonomy and supportive leadership-may warrant further exploration alongside individual-level approaches. Safeguarding sleep health in this population is important for both individual well-being and public safety.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"601666"},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Sleep Quality of Han Chinese and Tibetan Firefighters at High Altitude: A Field Study.","authors":"Xugang Tang, Luxun Tang, Shuang Li, Xuedong Gu, Xue Li, Xiaoyu Li, Wen Jiang, Qiang Wang, Yongjian Yang","doi":"10.2147/NSS.S591315","DOIUrl":"10.2147/NSS.S591315","url":null,"abstract":"<p><strong>Background: </strong>The sleep quality of Han Chinese and Tibetan firefighters at high altitude remains poorly understood. This study investigates the prevalence of sleep disturbances in these groups and whether ethnicity affects sleep quality in these two populations.</p><p><strong>Methods: </strong>Male firefighters were recruited from China Fire and Rescue stations at high altitude of 500 m, 2570 m, and 4509 m in Southwest China. The Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality, considering scores >5 as poor sleep quality. Symptoms of anxiety and depression were evaluated using the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9).</p><p><strong>Results: </strong>As altitude increased, the total PSQI scores of Han Chinese firefighters showed a non-statistically significant rise: 4 (2-5) at 500 m, 4 (3-6.75) at 2570 m, and 5 (2.75-6) at 4509 m. Poor sleep quality prevalence also rose: 23%, 31%, and 44%, respectively. In contrast, the sleep quality of Tibetan firefighters remained relatively stable and was better than that of their Han Chinese counterparts. Furthermore, the GAD-7 and PHQ-9 scores were higher in Han Chinese firefighters compared to Tibetan firefighters. The PSQI score was positively correlated with GAD-7 scores (<i>ρ</i> = 0.454, <i>p</i> < 0.001) and PHQ-9 scores (<i>ρ</i> = 0.380, <i>p</i> < 0.001) but negatively correlated with Tibetan ethnicity (<i>ρ</i> = -0.228, <i>p</i> < 0.001). Logistic regression analysis indicated that, compared to Tibetans, being Han Chinese (odds ratio [OR] = 3.050, 95% confidence interval [CI]: 1.214-7.665) and having higher GAD-7 scores (OR = 1.816, 95% CI: 1.332-2.477) were independently associated factors for poor sleep quality.</p><p><strong>Conclusion: </strong>This study suggests that Han Chinese firefighters in this field sample across these stations are at greater risk of poor sleep quality than Tibetan firefighters, with elevated GAD-7 scores being a potential contributing factor for poor sleep quality.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"591315"},"PeriodicalIF":3.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Validation of an AI-Based Snoring Model vs. Wearables for Diagnosing Sleep Apnea.","authors":"Haoyan Guan, Junyu Huang, Danling Liu, Long Yang, Hao Zeng, Jingjing Huang, Beiping Miao","doi":"10.2147/NSS.S582714","DOIUrl":"10.2147/NSS.S582714","url":null,"abstract":"<p><strong>Background: </strong>Sleep apnea-hypopnea syndrome (SAHS) has high prevalence and cardiovascular/cerebrovascular comorbidities. Polysomnography (PSG) is the diagnostic gold standard but limited by complexity, cost, and accessibility; smart wearables are convenient but less accurate. This study validated an AI-based snoring-sound model and compared its diagnostic performance with a wearable, using PSG as reference.</p><p><strong>Methods: </strong>Adults with suspected SAHS (n = 134) were included and underwent overnight PSG, with simultaneous snoring sound and wearable signal recording. The snoring algorithm used short-time Fourier transform (STFT) spectrograms and a multiscale encoder-attention-decoder neural network for classification. Model performance was assessed using correlation analysis, intraclass correlation coefficient (ICC), Bland-Altman plots, and receiver operating characteristic (ROC) analyses. Accuracy, sensitivity, specificity, and area under the curve (AUC) values were computed for both models.</p><p><strong>Results: </strong>Disease severity was associated with variation in BMI (p < 0.001) and decreasing oxygen saturation (p < 0.001). The snoring model showed stronger correlation and higher agreement with PSG-derived AHI (r = 0.79, ICC = 0.753) than the wearable (r = 0.68). Although the snoring model yielded consistently higher AUCs, particularly in mild SAHS (AUC = 0.83 vs. 0.72, p = 0.07), the differences between methods were not statistically significant (all p > 0.05). Both models achieved excellent discriminative performance in severe SAHS (AUC ≥ 0.90).</p><p><strong>Conclusion: </strong>The AI-driven snoring-sound model demonstrated comparable overall performance and numerically better performance in certain settings, particularly in identifying mild SAHS.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"582714"},"PeriodicalIF":3.4,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Esketamine on Postoperative Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Jiacheng Zhao, Yanan Yan, Xiaohan Wang, Chao Zhang, Jie Wang","doi":"10.2147/NSS.S575454","DOIUrl":"10.2147/NSS.S575454","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative sleep disturbances are common and deleteriously affect patient recovery, yet effective pharmacologic interventions remain limited. Esketamine has demonstrated analgesic and antidepressant properties, but its effect on postoperative sleep quality is unclear. To assess the impact of perioperative esketamine on subjective sleep quality in adult surgical patients.</p><p><strong>Patients and methods: </strong>Randomized controlled trials (RCTs) comparing esketamine with placebo, standard care, or other sedatives were retrieved from PubMed, Embase, and the Cochrane Library up to September 1, 2025. The primary outcome was postoperative subjective sleep quality, measured by validated scales. Secondary outcomes included incidence of sleep disturbance, pain scores, anxiety, depression, and quality of recovery (QoR-15). Subgroup analyses were prespecified by dose, timing, and dexmedetomidine co-administration. Among 21 included RCTs, 15 studies with 6880 participants reported postoperative subjective sleep quality.</p><p><strong>Results: </strong>The baseline sleep scores were comparable between esketamine and control groups. On postoperative day 1, esketamine significantly improved sleep quality (SMD = -0.40, 95% CI [-0.59, -0.20], I² = 72%, p < 0.0001). Subgroup analyses indicated that higher doses (> 0.25 mg/kg) and intraoperative administration yielded larger effects. Esketamine also significantly decreased the incidence of postoperative sleep disturbance, reduced pain scores, and improved QoR-15. No significant effects were found for anxiety or depression outcomes.</p><p><strong>Conclusion: </strong>Perioperative esketamine significantly enhances subjective sleep quality, reduces sleep disturbance incidence, and also confers analgesic and recovery benefits.</p><p><strong>Systematic review registration: </strong>www.crd.york.ac.uk/PROSPERO/, identifier, CRD420251138011.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"575454"},"PeriodicalIF":3.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13158264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Doses and Predictors of Dexmedetomidine for Inducing Specific Sleep Stages (N2/N3) in Chronic Insomnia: A Retrospective Cohort Study.","authors":"Zhenxiu Liu, Zhouquan Wu, Renqun Wang, Dandan Yin, Huichan Xv, Panqi Wang, Fuhai Ji, Jingjing Shen","doi":"10.2147/NSS.S600787","DOIUrl":"10.2147/NSS.S600787","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine (DEX) has emerged as a potential agent for sleep modulation; however, the effective doses required to induce multimodal electroencephalography (EEG)-defined sleep stages in patients with chronic insomnia remain unclear.</p><p><strong>Objective: </strong>This study aimed to quantify the cumulative DEX doses required to induce non-rapid eye movement (NREM) stage N2 and N3 sleep and to identify clinical predictors of dose variability.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, we analyzed 252 adults with chronic insomnia who underwent standardized intravenous DEX titration under continuous multimodal EEG monitoring. The primary outcomes were the cumulative DEX doses (µg) required to induce sustained N2 or N3 sleep. Univariable and multivariable linear regression models were used to identify independent predictors, including body mass index (BMI), depressive symptom severity assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS), and other clinically relevant covariates. Restricted cubic spline analyses were performed to examine potential nonlinear associations between BMI and DEX dose. Prespecified subgroup analyses stratified by age (<60 vs. ≥60 years) were conducted to assess effect modification.</p><p><strong>Results: </strong>The median effective dose was 40 µg (interquartile range [IQR], 33-48) for N2 sleep induction and 55 µg (IQR, 48-64) for N3 sleep induction. BMI was independently associated with higher DEX dose requirements for both N2 (adjusted β = 0.71; 95% CI, 0.25-1.17; P = 0.003) and N3 sleep (adjusted β = 0.48; 95% CI, 0.07-0.89; P = 0.022). Higher MADRS scores were independently associated with increased DEX dose for N2 sleep induction (adjusted β = 0.17; 95% CI, 0.01-0.34; P = 0.041) but not for N3 sleep. Restricted cubic spline analyses demonstrated significant overall associations between BMI and DEX dose for both sleep stages, while tests for nonlinearity were not statistically significant. Age was not significantly associated with DEX dose requirements, and no significant interaction by age group was observed.</p><p><strong>Conclusion: </strong>In patients with chronic insomnia, higher cumulative doses of DEX are required to induce deeper NREM sleep stages. BMI is a key determinant of DEX dose requirements for both N2 and N3 sleep, whereas depressive symptom severity appears to selectively influence N2 sleep induction. These findings support the use of individualized, multimodal EEG-guided DEX titration strategies and provide preliminary data to inform future prospective dose-finding studies.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"600787"},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep and Subjective Age: A Narrative Review of Epidemiological Evidence, Underlying Mechanisms, and Population Differences.","authors":"Mingkun Dai, Xiao Kuang, Yifei Wang, Wenlin Tai","doi":"10.2147/NSS.S584233","DOIUrl":"10.2147/NSS.S584233","url":null,"abstract":"<p><p>Subjective age-how old an individual feels-is a robust predictor of health outcomes and mortality independent of chronological age. Sleep, as a fundamental and modifiable health behavior, has been increasingly implicated as a determinant of subjective aging, yet the evidence remains fragmented across disciplines. This narrative review synthesizes current knowledge on the association between sleep problems and subjective age by critically appraising epidemiological evidence, delineating potential mechanistic pathways, and examining population-level moderators. Converging evidence from cross-sectional surveys, longitudinal cohorts, and one randomized crossover trial consistently demonstrates that poor sleep quality and insufficient sleep are associated with older subjective age. Daytime sleepiness is the only mediator with preliminary empirical support; additional candidate pathways-including accelerated brain aging, cortisol rhythm dysregulation, impaired emotional regulation, and appearance-related social feedback-remain theoretically plausible but empirically untested. The association appears stronger in women, middle-aged and older adults, and morning chronotypes, although moderator evidence is limited. Critical gaps persist, including the absence of chronic sleep intervention trials in older populations, near-exclusive reliance on self-reported sleep measures, and insufficient mechanistic research. Future priorities include prospective studies integrating objective sleep assessment, randomized trials of evidence-based sleep interventions targeting subjective age in midlife and older populations, and direct testing of the proposed multi-level mechanistic framework. These findings position sleep health as a promising yet underexplored leverage point for promoting psychological healthy aging.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"584233"},"PeriodicalIF":3.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13156964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Relationship Between Sleep Quality and Night Eating Syndrome in Overweight Iranian Medical Students.","authors":"Nazanin Alghasi, Ashley-Raye Miles, Amy M Bender, Leeba Rezaie, Nader Salari, Mahdi Aghajani, Habibolah Khazaie","doi":"10.2147/NSS.S571790","DOIUrl":"10.2147/NSS.S571790","url":null,"abstract":"<p><strong>Background: </strong>Night Eating Syndrome (NES) is an eating disorder linked to sleep disturbances, overweight status, and reduced quality of life. This study investigated the relationships among NES, sleep quality, and weight-related issues among medical students at Kermanshah University, a population prone to high stress and irregular routines.</p><p><strong>Methods: </strong>This correlational analytical study included 353 medical students recruited via quota sampling (2022-2023). Participants completed an online survey comprising demographic data, the Night Eating Questionnaire (NEQ), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using independent <i>t</i>-tests, Mann-Whitney <i>U</i>-tests, and Pearson correlation via SPSS version 24 to examine associations between NES, PSQI, and BMI.</p><p><strong>Results: </strong>The study found a low prevalence of clinical NES (0.8%), while 27.2% of students had poor sleep quality and 7.4% were overweight. There was a positive correlation between NES and PSQI global scores (r= 0.196, p <0.001), as well as with subjective sleep quality, sleep latency, medication use, and daytime dysfunction (p<0.05). Furthermore, NES was significantly more prevalent among overweight students compared to non-overweight students (p<0.01).</p><p><strong>Conclusion: </strong>While clinical NES was rare among Iranian medical students, significant correlations were observed between NES, sleep quality, and BMI. Future longitudinal studies are recommended to clarify the causal pathways linking these variables. Additionally, interventions targeting sleep quality and stress management may help reduce night eating behaviors and associated weight outcomes.</p>","PeriodicalId":18896,"journal":{"name":"Nature and Science of Sleep","volume":"18 ","pages":"571790"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}